DOUGLAS C WALLACE (NPI# 1063451144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063451144 |
| Entity Type | Individual |
| Full Name | DOUGLAS C WALLACE |
| Other Name | DOUGLAS CRAIG WALLACE |
| Credential | MD |
| Practice Address |
3154 Park St Grove City OH 43123-3222 |
| Practice Telephone | 6148750011 |
| Practice Fax Number | 6145397287 |
| Mailing Telephone | 6148750011 |
| Mailing Fax Number | 6145397287 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35.049780 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0586996 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376698753 | Douglas W. Wallace | Oral & Maxillofacial Surgery | 5188 Winton Rd, Fairfield, OH 45014-2900 | 2007-01-24 |
| 1730794041 | Douglas Wallace | Hearing Instrument Specialist | 95 Post Office Park, Wilbraham, MA 01095-1248 | 2020-09-14 |
| 1285098806 | Douglas Wallace | Emergency Medicine | 625 19th St S, Birmingham, AL 35233 | 2016-04-09 |
| 1811181498 | Douglas Cecil Wallace | Medical Genetics, Ph.D. Medical Genetics | 2014 Hewitt Hall, University of California Irvine, Irvine, CA 92697-3940 | 2007-08-28 |
| 1013058932 | Douglas Mckay Wallace | Psychiatry & Neurology | 1201 Nw 16th St, Miami Va Medical Center, Dept of Neurology, Miami, FL 33125-1624 | 2007-02-12 |
| 1851470033 | Douglas Charles Wallace | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3900 St Francis Way, Ste 201, Lafayette, IN 47905-4923 | 2006-11-06 |
| 1881657989 | Douglas M Wallace | Emergency Medicine | 101 E Wood St, Spartanburg, SC 29303-3040 | 2006-04-10 |
| 1083608053 | Douglas W Wallace | Radiology | 2300 Manchester Expy, Ste A001, Columbus, GA 31904-6802 | 2005-09-07 |
| Street Address |
3154 PARK ST |
| City | GROVE CITY |
| State | OH |
| Zip Code | 43123-3222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760896716 | Melissa Kay King | Nurse Practitioner | 3154 Park St, Grove City, OH 43123-3222 | 2014-06-18 |
| 1588606784 | Francisco C Buendia Jr. | Family Medicine | 3154 Park St, Grove City, OH 43123-3222 | 2006-06-12 |
| 1336188861 | American Health Network of Ohio, LLC | Respiratory Therapist, Registered | 3154 Park St, Grove City, OH 43123-3222 | 2006-06-06 |
| 1194764373 | Richard Matthew Janczak | Family Medicine | 3154 Park St, Grove City, OH 43123-3222 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376165225 | Leetonya Henley | Registered Nurse | 4499 Rishel Street, Grove City, OH 43123 | 2020-05-14 |
| 1235792268 | Yunbo Tian | Student in an Organized Health Care Education/Training Program | Transitional Year, 5300 North Meadows Dr., Grove City, OH 43123 | 2019-04-16 |
| 1316402845 | Kristina Wojcik | Counselor | 5665 Hoover Road, Grove City, OH 43123 | 2019-02-08 |
| 1487134581 | Orthopedic One, Inc. | Orthopaedic Surgery | 5500 N. Meadows Drive, Grove City, OH 43123 | 2018-08-17 |
| 1699253658 | Ohiohealth Corporation | Pharmacy | 1375 Stringtown Road, Grove City, OH 43123 | 2018-08-01 |
| 1881102911 | Buckeye Anti-aging and Aesthetics | General Practice | 3699 Garden Ct, Grove City, OH 43123 | 2018-01-10 |
| 1093221764 | Alonda Shantel Long | Case Manager/Care Coordinator | 5665 Hoover Rd., Grove City, OH 43123 | 2017-12-18 |
| 1417466673 | Robert William Frazier Jr. | Social Worker | 3770 Santa Maria Dr., Grove City, OH 43123 | 2017-09-20 |
| 1053830885 | Grove City Surgery Center LLC | Clinic/Center | 1325 Stringtown Rd, Suite 100, Grove City, OH 43123 | 2017-09-13 |
| 1295253292 | Lori Little | Adult Companion | 5233 Thornhill Ct, Grove City, OH 43123 | 2017-08-30 |
| Find all providers in zip 43123 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948667 | Grace Laszlo | Family Medicine | 2385 Creek View Pl, Grove City, OH 43123-1518 | 2020-09-29 |
| 1962856302 | Kristen Mary Lafferty | Family Medicine | 2030 Stringtown Rd Ste 200, Grove City, OH 43123-3993 | 2016-04-22 |
| 1033571765 | Evelyn Ann Eakin | Family Medicine | 1325 Stringtown Rd Ste 240, Grove City, OH 43123 | 2016-03-22 |
| 1942679790 | Allegheny Clinic | Family Medicine | 201 Erie St Ste C, Grove City, PA 16127-1659 | 2015-09-23 |
| 1093957060 | Charles H Grande | Family Medicine | 1440 Carrie Way, Grove City, PA 16127-1045 | 2009-04-06 |
| 1346419371 | Sarah Renee Adams | Family Medicine | 3667 Marlane Dr, Grove City, OH 43123-8895 | 2008-02-25 |
| 1114018454 | Ambareen A. Bharmal | Family Medicine | 5350 N Meadows Dr, Suite 160, Grove City, OH 43123-2546 | 2006-09-28 |
| 1982708269 | Stephanie T Flowers | Family Medicine | 3667 Marlane Drive, Grove City, OH 43123 | 2006-09-08 |
| 1659316644 | Grove City Family Health, Inc | Family Medicine | 6024 Hoover Road, Suite A, Grove City, OH 43123-8131 | 2006-06-17 |
| 1780644039 | Raymond M Pongonis Do, Inc. | Family Medicine | 2407 Sportsman Dr, Grove City, OH 43123-3987 | 2006-03-23 |
| Find all providers in GROVE CITY | ||||
| City | GROVE CITY |
| Zip Code | 43123 |
Please comment or provide details below to improve the information on DOUGLAS C WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.